January 21, 2000

From left, Austen and Mongan unseal the book.

The Ether Dome was once again the site of a historical event Jan. 12 as members of the General Executive Committee (GEC) opened a book that was sealed nearly 40 years ago and left as a time capsule.

The book, which was wrapped in brown paper and sealed with wax, displayed the cryptic message: "Probable future patterns of medical practice at MGH. Not to be opened until 2000 AD." James J. Mongan, MD, president of the MGH, and W. Gerald Austen, MD, chairman of the Massachusetts General Physicians Organization, unveiled the volume at the first GEC meeting of the new millennium.

In the book was a collection of letters submitted by MGH staff physicians in 1961. These letters responded to a request by Edward Churchill, MD, chief of Surgery at the time, for opinions about the effectiveness of the MGH Staff Associates, the medical group practice established in accordance with a GEC resolution in 1952. This organization was meant to coordinate the physician staff into a group practice rather than having separate practices affiliated with the MGH.

Churchill asked staff to be candid with their opinions including "giving their views, their hopes, their fears (if any), their predictions, and their suggestions as to what steps should be taken by the hospital to assist in the best possible development of the practice of its staff members."

More than 90 staff responded with a wide variety of comments. The feedback touched upon improving patient services, hospital plant and facilities, new construction, communications within the hospital, factors influencing patient census, public relations with the community and medical profession at large, issues with recent graduates and the nursing service, parking and elevator problems and the "lack of ordinary cleanliness."

Churchill prepared a 48-page summary of the staff responses in which he included his plans for preserving the letters for the future. "The letters will be placed in a sealed envelope and deposited in the MGH Archives, marked 'Not to be opened until the year 2000 AD.' At that time some curious member of the MGH staff may brush off the dust and say 'Who were these fellows back in 1961? And, why were they arguing about such obvious matters?' "

Below are a few of the more interesting or unusual excerpts from the book:

I simply wish to state that I am unalterably opposed to any scheme which will make staff doctors employees of the Massachusetts General Hospital.

I recommended in 1948 that the MGH Staff Associates form a Group Clinic in the employ of the Trustees. I feel that we have wasted a great deal of time in not doing so.

While I admittedly know very little about the MGH Staff Associates, from all that I have been able to learn about it, it is a form of union. I find it hard to understand how this or any other union will preserve the crucially important values of freedom and initiative.

We consider it important that the MGH reestablish an Obstetrical Unit so that this hospital can provide total service to such groups.

We suggest that various ways of solving the parking problem for patients having appointments be explored.

It has been predicted that average costs per day for private hospital care will go to $60 per day by the 70s.

[There is a] lack of proper attention to the maintenance and intelligent operating of all the hospital elevators.

I hate to be a status quo man, but I am very happy with things as they are.

I would like to see the hospital pioneer in the establishment of a more equitable fee for services amongst the various specialists. I grant you this will be difficult as the prevailing wind in our society favors the Cadillac and the movie star and that the present era insurance plans are designed by and for the surgeon.

From the point of view of the hospital, future patterns of medical practice must attract and hold doctors in every field who will spontaneously strive to equal or better the scientific achievements of their predecessors.

Some visitor once warned us: 'You have something precious and unique at the Massachusetts General Hospital; you should hang onto it.' And we have hung onto it, somehow, despite all the changes that are taking place in the world around us.